Anticoagulants Flashcards
Heparin mechanism
Strong - charge that inhibits clotting by activating enzymes lipoprotein lipases - injected
Inhibits factor X, thrombin IX, XI and XII
Degraded by heparinase
Heparin side effects and treatment of overdose
Bleeding
Osteoporosis, HIT, hypersensitivity
Treated with protanine sulfate
Low MW heparins
Enoxaparin, dalteparin
Half life - 4 hours
More effect on X
Not reversed by protanine sulfate
Heparin-like drug
Fondaparinus
Half life - 17 hours
Acts on X
Passes through placenta
Leech
Hirudin in saliva
Inhibits thrombin
Used when patient has HIT
3 synthetic analogs of hirudin
Bivalirudin, desirudin, argatroban
Warfarin
Inhibits an enzyme that allows vitamin K to be recycled - prevents factor VII, IX, X and prothrombin synthesis
p450
S.E.: hemorrhage, pregnancy category X
Direct thrombin inhibitor
Dabigatran - prodrug - works within 1 hour
Hemorrhage
Factor Xa inhibitors - 2
Rivaroxaban, apixaban
Rapid onset
Bleeding after spinal surgery
Thrombin receptor blocker
Vorapaxar
Blocks platelet thrombin receptor
Be careful for intracranial bleeding past
ADP inhibitors - 4
Ticlopidine, clopidogrel, prasurgrel, ticagrelor
S.E.: neutropenia, agranulocytosis
Fibrinogen receptor inhibitors - 3
Abciximab, tirofiban, eptifibatide - given IV
Prevent platelet aggregation
Can cause thrombocytopenia
COX inhibitor
Aspirin
Inhibits TAX2 synthesis - decreases platelet aggregation
Cyclooxygenase inhibitor
Phosphodiesterase inhibitors - 2
Cilostazol, dipyridamole
Inhibit enzyme that breaks down cAMP
Platelet count reducer
Anagrelide
Decreases platelet formation, maturation and #
